Provider First Line Business Practice Location Address:
144 CHILTON STREET
Provider Second Line Business Practice Location Address:
CHILTON PEDIATRICS LLC
Provider Business Practice Location Address City Name:
ELIZABETH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07202-1448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-659-0429
Provider Business Practice Location Address Fax Number:
908-659-1559
Provider Enumeration Date:
01/30/2007